Quiz: White Pupil

TYK 10 19 17

This 2 ½-year-old girl presents with a white pupil as shown above. The parents have noted this appearance for 6 months.

Last Updated: October 31, 2022

9 thoughts on “Quiz: White Pupil”

  1. Is the pupil dilated pharmacologically? I would go for retinoblastoma first.the leucocoria appears rather deeper than I’d expect in a cataract. There appears to be an esotropia too, which could be from either.nevertheless, urgent work up and manage accordingly.

  2. the picture actually looks cataract than retinoblastoma however it not out of place to choose retinoblastoma since it’s the most severe one so as to place safe but the retina state should have been stated or given as a clue.

  3. The photo appears to be more of cataract then retinoblastoma. Sure, retinoblastoma HAS to be ruled out in each and every case of leukokoria, but the question was on what the likely diagnosis was BASED on the photo.

    In one of your Q&A section it is mentioned that the whole retina is involved, but the photo does not reveal any retinal vessels or other features suggestive of a detached retina.

    Again, the photo is more suggestive of cataract then retinoblastoma, however all ophthalmologists will rule out retinoblastoma in each and every case of leukokoria.

    You should have provided photos after dilatation of pupil too.

    • You are quite right, cataract is more common than retinoblastoma, however, this photo shows a “white reflex” rather than a white cataract. Perhaps subtle but the leukocoria shown in this photo (of a dilated pupil) has a luminescent glow to it as the white, calcified retinoblastoma is reflecting the flash from the camera. Total cataracts are white but do not share this same luminescent reflection.


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